AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
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<strong>AGES</strong> <strong>XXIII</strong> <strong>Annual</strong> <strong>Scientific</strong> <strong>Meeting</strong> <strong>2013</strong><br />
Free Communications Chairmen’s Choice - Friday 8 March<br />
SESSION 7 - Free COMMUNICATIONS<br />
Chairmen’s Choice / 1440-1450<br />
Depot medroxyprogesterone acetate (DMPA) in<br />
the treatment of endometriosis<br />
Vollenhoven B, Dennerstein G, Fernando S, Fraser<br />
I, Polyakov A, Vu P, Wark JD<br />
This is an account of 141 consecutive women diagnosed with<br />
endometriosis and treated with DMPA injections between<br />
1973 and 2011 in one gynaecological private practice.<br />
The data were collected prospectively and entered in a<br />
purpose-made database. Many individuals were treated over<br />
prolonged periods of time. Dosages were given according to<br />
recommended schedules for endometriosis, usually 150mg<br />
every 3 months.<br />
The data have been analyzed with regard to duration and<br />
success of the treatment and side effects, including the effect<br />
on bone mineral density.<br />
Pelvic pain was relieved with a high degree of success and<br />
limited side-effects (in line with published data). Bone<br />
mineral density measurements show no significant difference<br />
from a normal female population collected in the same city<br />
using the same hospital-based BMD practice.<br />
It is concluded that DMPA is a safe and effective treatment<br />
that should be offered as an alternative long-term medical<br />
option to all women diagnosed with endometriosis who do<br />
not wish to conceive within 12 to 18 months. Published data<br />
on this option are very limited, but anecdotally it is used<br />
widely around the world for endometriosis.<br />
AUTHOR AFFILIATION: B. Vollenhoven 1 , G. Dennerstein 2 ,<br />
S. Fernando 1 , I. Fraser 3 , A. Polyakov 4 , P. Vu 1 , J. D. Wark 5 ;<br />
1. Monash Medical Centre, Clayton, Victoria, Australia.<br />
2. Melbourne University, Melbourne, Victoria, Australia.<br />
3. Sydney University, Sydney, New South Wales, Australia.<br />
4. Melbourne IVF, East Melbourne, Victoria, Australia.<br />
5. Royal Melbourne Hospital, Parkville, Victoria, Australia.<br />
SESSION 7 - Free COMMUNICATIONS<br />
Chairmen’s Choice / 1450-1500<br />
Retrospective clinical audit reviewing the use of<br />
Magnetic Resonance guided Focused Ultrasound<br />
(MRgFUS) in the treatment of submucosal uterine<br />
fibroids at the Royal Women’s Hospital Melbourne<br />
Rajadevan N, Szabo R, Dobrotwir A, Ang WC<br />
of fibroids is increasing, effective treatment options which<br />
relieve symptoms whilst also preserving fertility are<br />
becoming increasingly more important. MRgFUS provides<br />
one such treatment alternative.<br />
AIM: To review all cases of submucosal uterine fibroids<br />
treated by MRgFUS at the Royal Women’s Hospital<br />
Melbourne between 2009-2012 over the first 30 months of<br />
MRgFUS related experience. Specific outcomes assessed<br />
included treatment success as defined by a reduction in<br />
symptom severity score measured at 4 and 12 months posttreatment,<br />
fibroid volume shrinkage and features predictive<br />
of treatment failure.<br />
METHODS: A retrospective clinical audit was undertaken<br />
of 62 women who underwent treatment with MRgFUS for<br />
at least one submucosal fibroid over the initial 30 month<br />
treatment period at the Royal Women’s Hospital Melbourne.<br />
Patients were identified through a database maintained by<br />
the Radiology department and data regarding demographics,<br />
clinical characteristics and treatment outcomes was obtained<br />
through the clinical results database and individual patient<br />
hospital records.<br />
RESULTS: Of the 62 patients identified, 39 (62.9%) of<br />
patients were successfully treated by MRgFUS with a<br />
decrease in symptom severity score at 4 months whilst at 12<br />
months 32 (59.3%) of patients were considered to have been<br />
successfully treated. Ten patients (16.1%) required further<br />
intervention despite treatment with MRgFUS including<br />
either hysterectomy or open, laparoscopic or hysteroscopic<br />
myomectomy. Patients who failed MRgFUS treatment were<br />
more likely to be of a younger age (40.4 vs 42.7yrs), decreased<br />
parity (0.6 vs 1.1) and with an increased overall uterine and/<br />
or fibroid volume (mean uterine volume 520.8 vs 490.8mL).<br />
Overall reduction in treated fibroid volume also varied<br />
between those who were treated successfully in comprison to<br />
those who failed treatment.<br />
CONCLUSION: In selected cases for the treatment of<br />
submucosal fibroids MRgFUS provides a safe and suitable<br />
treatment alternative. Whilst further studies are required<br />
to more fully determine long-term outcomes and optimal<br />
patient characteristics, the benefits of MRgFUS over other<br />
treatment modalities include its non-invasive nature,<br />
relatively low complication rate, quicker recovery and<br />
preservation of fertility.<br />
AUTHOR AFFILIATION: N. Rajadevan, R. Szabo, A.<br />
Dobrotwir, W. C. Ang; Royal Women’s Hospital Parkville,<br />
Victoria, Australia.<br />
BACKGROUND: Uterine fibroids are hormonally dependent<br />
with a maximal incidence during the reproductive years<br />
and are reported to occur in 20-40% of reproductive aged<br />
women and are clinically apparent in approximately 12-25%.<br />
Symptoms attributable to uterine fibroids are generally<br />
classified into three categories: abnormal uterine bleeding,<br />
pelvic pressure and pain and reproductive dysfunction. A<br />
number of treatment alternative are available. However,<br />
given the tendency for women to start a family at an age<br />
where natural female fertility is in decline and the incidence<br />
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